Opioid Ties to Industry and Advocates Explored

On May 8, 2012, Senators Max Baucus (D-Montana) and Charles E. Grassley (R-Iowa) sent letters to advocacy groups, drug makers, and academic experts requesting records be provided to the Senate Finance Committee documenting financial and other ties within the industry as part of an inquiry to ensure that doctors and patients were receiving accurate information about opioid medications’ risks and benefits.

Narcotic painkillers, referred to as opioids, such as OxyContin, Vicodin, and methadone are the most widely prescribed class of drugs in the United States. In the last decade, the number of prescriptions doctors write annually has jumped fourfold. There is growing concern that patients face significant risks from these drugs when they are used at high doses or over long periods. Opioids were involved in 14,800 overdose deaths in 2008, more than cocaine and heroin combined, according to the U.S. Centers for Disease Control and Prevention. Some critics contend that experts and organizations tied to the drug industry have exerted too much influence over how the drugs are regulated and how doctors perceive them in their prescription patterns.

In its letter to Purdue Pharma, the committee requested a detailed account of all payments from 1997 to the present between Purdue and organizations, including, but not limited to: (1) The American Academy of Pain Medicine; (2) Beth Israel Medical Center, Department of Pain Medicine and Palliative Care; (3) The American Pain Society; and (4) The American Geriatric Society. The pharmaceutical was given until June 8, 2012, to respond to the committee.

Although it was not clear as to whether the Senate Finance Committee investigation factored into the decision, a leading advocacy organization said it was dissolving immediately “due to irreparable economic circumstances.” The American Pain Foundation, which described itself as the nation’s largest organization focused on patients’ pain, was the subject of a December investigation by ProPublica (also printed in The Washington Post) that detailed its close ties to drug makers. Ninety percent of the group’s $5 million in funding in 2010 was sourced from the drug and medical-device industry and its guides for patients, journalists and policymakers minimized some risks associated with opioid painkillers while exaggerating other benefits from the drugs.

The Senate inquiry also follows a study in The Journal of the American Medical Association that quantified the sharp growth of a potential opiate abuse problem in pregnant women. The study estimated that every hour a baby is born in the United States with symptoms of withdrawal from opiates — roughly 13,500 babies a year. The condition, known as neonatal abstinence syndrome, can cause seizures, breathing problems, dehydration, difficulty feeding, tremors and irritability. Infants are hospitalized for several weeks while doctors treat them with methadone or morphine to wean them from their dependence on the drugs that their mothers used.